Crutches may be stopped within 1 week as long as the patient has full extension, can perform a straight leg raise without an extension lag, and ambulates without a limp. Patients may be weaned to one crutch (opposite arm, after 3 weeks) in order to normalize gait (no limp) and as long as full extension and no extension lag with straight leg raises are obtained.

Toe raises with weights, step-ups (begin with 2 inches and progress to a full step)

Crutches should be weaned off in this stage, and gait should be normal – if not, contact Dr. Berkbigler

3 to 6 weeks:

1 to 2 visits per week, 5 times a week home program

Continue all exercises in previous phase (as described above)

Focus rehabilitation towards more closed-chain exercises including leg presses, step-ups, mini-squats, leg extensions, and hamstring curls with light weights, high repetitions. Repetitions should be smooth and slow and NOT explosive. May begin jump rope exercises. May advance to swimming.

Endurance closed-chain quadriceps exercises should begin such as Stairmaster, stationary bike, elliptical trainer, Nordic trac, etc. Focus on increasing endurance and should be performed 3 to 4 times per week.

If a pool is available, swimming may started at 1 month

Gait and range of motion should be normal by 4 weeks. If it is not, contact Dr. Berkbigler

Begin slow jogging (if allowed) and progress to slow running on even ground or treadmill, no cutting, jumping or pivoting (once range of motion is full and patient has full quadriceps control and if impact exercises are allowed)

6 weeks to 3 months:

3 to 5 times a week home program. May need physical therapy supervision for functional training.